完整结肠系膜切除与传统方法在左半结肠癌根治术的对比研究  

Complete mesocolic excision versus traditional resection in radical surgery for left-sided colon cancer

作　　者：韩伟峰[1] 费伯健[1] 金留根[1] 曹华祥[1] 蒋晖[1] 王卫理[1] 许示心[1] 

机构地区：[1]江南大学附属医院 无锡市第四人民医院普通肿瘤外科,江苏214062

出　　处：《临床外科杂志》2014年第9期676-678,共3页Journal of Clinical Surgery

摘　　要：目的：探讨完整结肠系膜切除（complete mesocolic excision，CME）在左半结肠癌根治术中的临床应用价值。方法回顾分析2011年1月至2013年10月期间48例CME左半结肠癌根治术及2009年1月至2010年12月间42例传统手术患者的临床资料，对比两组手术效果。结果CME组清扫淋巴结均数明显多于传统手术组，差异有统计学意义（22．31±2．60 vs 17．29±2．72， P＜0．0001），Ⅰ、Ⅱ、Ⅲ期患者淋巴结增加差异均有统计学意义。CME组Ⅲ期患者根部淋巴结转移率10．99％（10/91）。在手术时间、术中出血量、手术并发症和术后恢复等方面差异无统计学意义。结论 CME左半结肠癌根治术不增加手术风险，显著提高淋巴结清扫数量，具有安全性、可行性和有效性。Objective To evaluate the clinical value of complete mesocolic excision（CME）in the radical surgery for left-sided colon cancer.Methods The clinical data of 48 cases with CME and radical surgery for left-sided colon cancer from January 201 1 to October 2013 and 42 cases with traditional resec-tion from January 2009 to December 2010 were analyzed retrospectively.The surgical results were com-pared between groups.Results The number of dissected lymph nodes in CME group was significantly greater than that in the control group [（22.31 ±2.60）vs（17.29 ±2.72）,P〈0.0001].In patients with stageⅠ,ⅡandⅢ,the number of lymph nodes increased significantly（P〈0.05 ）.In patients with stageⅢ,the metastatic ratio of mesenteric lymph node was 10.99%（10/91）in CME group.There were no sig-nificant differences in mean operative time,intraoperative blood loss,complications and postoperative re-covery between the two groups.Conclusion In the radical surgery for left-sided colon cancer,CME could enhance the lymph nodes harvest,which does not increase the risk of operation.It is a safe,feasible and ef-ficacious method.

关 键 词：完整结肠系膜切除 左半结肠癌 左半结肠癌根治术 

分 类 号：R735.35[医药卫生—肿瘤]